In July 2016, Sandra Perez became the director of the California Program on Access to Care (CPAC), an applied policy research center hosted at UC Berkeley School of Public Health. Created at the behest of the California State Legislature, CPAC serves as a critical link between the expertise of the University of California faculty and policy makers in Sacramento to support effective public policymaking to improve health care access for the state’s most vulnerable populations.
Sandra has decades of experience working in and around the State Capitol. Most recently she was a principal consultant at the California State Senate Office of Research working on health policy to provide non-partisan research all 40 Senators, their staffs and committees. She was also staff to Assembly Speaker Willie Brown and Assemblyman Phil Isenberg. She was appointed by Governor Schwarzenegger to be the director of the Office of the Patient Advocate when he was developing his health reform plan. As a pre-med student, Sandra was also a health educator for farmworker families in the Delta.
Her work in higher education includes directing the nationally-renowned California Capitol Fellows Executive and Judicial Fellowship Programs at the Center for California Studies at California State University, Sacramento.
Sandra holds a bachelor’s degree in Community Health and Nutrition from the University of California, Davis; a master’s degree in Health Administration from the University of Southern California; and a master’s degree in Public Administration from Harvard University. She is also a graduate of the Harvard University’s Executive Leadership Program, the National Hispana Leadership Institute in Washington, D.C.; Sacramento Metropolitan Chamber of Commerce Leadership Sacramento; and the Center for Creative Leadership in La Jolla, California.
As the director of CPAC, Sandra sees herself as a conduit between the Legislature and UC researchers working to address the health care needs of vulnerable Californians. She will provide timely and relevant research from the UC to the Legislature by hosting briefings and roundtables in the Capitol and is amenable to bringing Sacramento’s public policy experts to the School of Public Health.
Improving Coverage and Access for the Undocumented Californians
An estimated 2.1 to 2.5 million Californians are undocumented immigrants. Under state law, counties are the “providers of last resort” for low-income, uninsured people with no source of care. Yet, undocumented Californians are not allowed to apply to Medicaid or receive Federal subsidies to acquire health care insurance coverage through Covered California, the state’s health insurance exchange created as part of the Affordable Care Act. There are a number of additional barriers to care for undocumented in CA, including financial, political, and cultural barriers. In order to address the lack of access to care and improve awareness of available health services for Undocumented adults, CPAC provides technical assistance for legislators, county public agencies and farmworker organizations focused on cultivating coverage expansion options, with an emphasis on policy innovations in the agricultural industry in the Central Valley and Inland Empire counties.
CPAC works toward the development of supportive policies to expand health insurance coverage and improve access to care for the remaining uninsured through policy reports, briefings, and roundtables that bring legislative and local county agency stakeholders together to develop collaborative solutions.
Improving Access to Behavioral Health Services and Supports
Depression and other mental health conditions are the leading cause of disability among individuals aged 15-44 in the US and in California. According to the Center for Disease and Control, young Latinas are nearly twice as likely as young Latinos to think about suicide and to attempt suicide. To address shortages in the behavioral health workforce in California’s low-income communities, CPAC prioritizes policy and technical assistance to enable expanded access to care for behavioral health issues, such as alcohol misuse, tobacco use, substance abuse, depression, and obesity. These behavioral health issues disproportionately impact low-income Latino communities facing major shortages of behavioral and mental health professionals.
CPAC’s technical assistance priorities related to the behavioral health workforce include identification and analyses of emerging workforce models for expanded access to behavioral health services and analyses of supportive policies such as scope of practice and role expansion for nurses, community health workers, and medical assistants. CPAC’s technical assistance to the legislature and county agencies include brief reports, Capitol briefings, and roundtables for collaborative problem-solving.
Enabling Innovation in the Medi-Cal Program
California has the largest Medicaid program in the nation at more than 13.4 million Californians, one-third of the state’s population. Known as Medi-Cal, the program has an operating budget of over $86 billion annually. The state’s expansion of Medi-Cal is by far the largest expansion of health insurance coverage to previously uninsured individuals of all states in the country, with over 3.9 million new enrollees. As Medi-Cal enrollment continues to grow, it faces numerous challenges, including assuring access to health services and controlling surging costs of care. To support the sustainability of Medi-Cal, CPAC works to support innovation in the Medi-Cal program through the development and analysis of policies and strategies to enable expanded enrollment through alternative funding options. CPAC also assists legislative, executive, state and local agency, and community partners in ensuring adequate provider reimbursement rates.
CPAC provides technical assistance to support informed decisions about policies and strategies that incentivize delivery system change and innovation for the most vulnerable segments of California’s population.
Successful Reintegration after Incarceration through Workforce Innovations
California has the largest number of prisoners in its correctional system of any state in the US, over 135,000 individuals, most of them being African-American and Latino men. Upon release, previously incarcerated individuals face many obstacles, including homelessness, unemployment, limited social relationships and support systems, and stigma. An estimated 1 in 10 parolees find themselves homeless upon parole and 60% -90% do not possess the necessary skills to complete their parole. Although a lot of funding goes into keeping people in prison, less than 5% of the Department of Correction’s annual budget goes to rehabilitation and integration efforts, which involve transitional accountability, community-based supervision and services, and community based programs.
CPAC works with faculty across the UC system and experts in successful reintegration after incarcertion to provide technical assistance to support the legislature, the executive branch, and local and state agencies to improve reintegration outcomes.